Aaron PowellNHS Blood and TransplantCIO 100 2017 - No. 20

Technology and digital are now firmly at the heart of what the NHSBT does, and Aaron Powell’s role is primarily to inspire and enable his colleagues to think about what technology could offer them in their business units. In 2016, he deployed the NHSBT’s first major business-critical application hosted in the cloud to manage workflow and safely allocate hearts or transplant. It has brought about significant safety improvements and reduced the risk of error, and was deployed in just eight months. He also transformed the way specialist nurses work by launching an iPad app that digitised 75 pages of complex forms and allowed nurses to collate the medical history and details of organ donors at the bedside. And he introduced automated text messaging to tell donors when their blood had been issued to a hospital – a hugely well-received initiative that has connected donors in a very direct way with the outcome of their donation.

Job titleChief Digital Officer

Company nameNHS Blood and Transplant

How are you influencing the products, customer experience and services your organisation offers to its customers?NHS Blood and Transplant is a complex organisation whose primary responsibility is the recruitment and retention of blood, organ and stem cell donors, the manufacturing and supply of blood components and other products, the delivery of specialised testing and therapeutic capabilities to the NHS, and the allocation of organs for transplant.

2016 was an important year for NHSBT’s technology and digital teams under my leadership and, as a team, we achieved a number of milestones.

We deployed our first major business-critical application hosted in the cloud – using IBM’s business process management and operational decision manager tools to manage the workflow and safely allocate hearts or transplant. This has already resulted in significant safety improvements, a reduction in the risk of error and – thanks to agile development techniques and the use of software as a service – was deployed in just eight months.

We launched DonorPath, an iPad app enabling our specialist nurses to collate the medical history and details of organ donors at the bedside, following their natural workflow, and specially designed to work both online and synchronise offline. The app digitised 75 pages of complex forms and has transformed the way specialist nurses work.

We continued to enhance our blood donor portal, used by over a million blood donors to manage their appointments, and introduced automated text messaging to tell donors when their blood had been issued to a hospital. This has been extremely well received and connects donors in a very direct way with the outcome of their donation.

Not forgetting our internal customers – the staff we serve – we introduced an online HR function badged PeopleFirst, with a range of self-service features for staff. This has been backed up with a new HR customer service team – HRDirect – which has handled over 35,000 queries since its launch and achieved customer service excellence certification in its first year. We also made significant improvements in the responsiveness and rate of first-contact resolution in our IT service desk.

Alongside all this, and without disruption to the business, we moved our core datacentres out of our own premises to an external co-lo arrangement, maintaining geographical resilience throughout. We upgraded our core database software, commenced the delivery of a new corporate WAN and LAN, and began the roll-out of a new Windows 10 desktop.

Technology and digital are now firmly at the heart of what we do, and my role has been largely to inspire and enable my colleagues to think about the range of possibilities that technology might offer them in their business units.

Define the key business outcomes that you have delivered over the last 12 months and their impact on your organisation’s performanceAlongside our corporate objectives, the drivers behind our technology transformation can be summed up in the mottos of two of our largest programmes. Our organ donation and transplantation programme is all about using technology to enable a safer, simpler and more supportive process, using automation to reduce the 97-plus manual steps previously involved in the allocation of organs for transplant; removing the need for transcription of data by ensuring that data is standardised and accessible wherever it is needed; and providing workflow solutions for our staff to enable them to focus on the specialist areas of their work.

In blood donation and manufacturing, our focus is on excellence in customer service, effective supply of blood to hospitals in the right product mix when they need it, and delivering an efficient supply chain. The first of these is absolutely critical to ensuring that we continue to attract and retain loyal donors, while the last is necessary to ensure that we maintain a sustainable supply in the context of a global decline in demand for blood, and reduce the overall costs to the NHS at a time of austerity.

What has been your involvement with innovation at your organisation – in particular, with products, business model and technology – over the last 12 months?

Product innovation

Most of the ‘products’ we supply are largely fixed – blood, blood components, tissues and (not strictly products) organs for transplant. While we have cutting-edge research programmes in, for example, manufactured red blood cells, our core opportunity for innovation is in the services that we offer to support our product mix. That said, a particular area of innovation supported by technology is the way we use cloud services to help us manage the substantial data volumes generated by, for example, genomic sequencing of some of our donors and patients. This is driving our ability to provide a better matched product which reduces the risk of harm. From a service perspective, we are increasingly digitising our interactions with hospitals and using a standards-based approach to exchange and manage data between us.

Business model innovation

Our business model is constantly evolving. Two of the key drivers for this are the need to ensure that we have accurate information about the potential demand for blood to ensure that we collect and maintain stocks of the right mix of blood groups, and the need to be more flexible in the way we manage donor appointments, ensuring that those whose blood is particularly needed are able to secure an early appointment to donate. Our technology, in particular the ability to analyse data and plan effectively, is central to these innovations.

We have also commenced a programme to automate more of the testing we need to carry out on blood, and implemented methods to support the integration of stem-cell registry systems internationally. In all of these areas of innovation my role has been to be a passionate advocate, encourage new thinking, and create the space for my teams and the business teams to collaborate effectively.

Technology innovation

Key areas of technology innovation in 2016 have been in extending the use of mobile services and harnessing the power of big data and analytics. Our DonorPath app, for example, is an innovative in the way it synchronises data supporting our specialist nurses in working both online and offline, reflecting the fact that connectivity is often difficult to achieve in hospitals. Under my leadership we have worked with the private sector to scope out a number of practical data analytics and machine learning trials to explore the insights that the large amounts of data we have on donor and patient outcomes might give us. We have deployed rapid innovations too – providing Wi-Fi connectivity in all of our therapeutic treatment centres for patient use in just weeks.

How have you delivered cultural and behavioural change as a CIO within the IT department and/or more broadly across the organisation?Last year I noted that I had introduced agile development approaches and placed them at the heart of our technology programmes. A major cultural change this year has been in realising the benefits of this approach, developing a collaborative culture between our business staff, the technology teams and external partners that we have brought in to accelerate our development. This collaboration has been critical in ensuring that our programmes have buy-in right across the organisation, and are seen as an opportunity to work together to innovate and improve, rather than as having technology done to them.

Within the IT department I have worked with key colleagues to introduce new ways of working for our development teams, establishing a robust configuration management capability and prepare the ground for an emerging dev/ops capability. On the service and operations side, we have established professional leadership for our technology families to foster ownership and innovation, and a robust service management framework driven by actionable metrics.

One of the most apparent changes for the organisation as a whole has been the extent to which, through leadership and challenge, we have made the language of digital and technology central to the organisation. In the same way that no manager could reasonably claim not to understand the financial numbers, we have made it an expectation that everyone will have a basic knowledge of key technology and digital concepts.

How have you worked with your CEO and/or board to communicate whatever ‘digital’ and IT means to your organisation/sector and improve digital literacy at the highest levels of the organisation?Recognising that digital is an often confused and abused word, I took the opportunity at our senior leaders conference last year to spell out what digital means for NHSBT – using the terms ‘connectedness’ and ‘personalisation’ to describe the changes that it should drive. Digital is, for us, about the way in which we join up our people, data and process across the different parts of our organisation and outside its boundaries in order to deliver a more personalised service to our donors, customers and staff. I have then taken this further by identifying a series of lenses or perspectives from which to view the organisation – from customer service, to supply chain, to matching and allocation – to identify digital exemplars and models we might follow. We call this our approach to ‘blood, organs and tissues in a connected world’.

We have established a digital champions network with participation from across the organisation to harness ideas and insight and challenge us to think bigger. This group meets regularly by webinar and has its own LinkedIn group.

Importantly, we have not left the board behind. I have run a series of seminars for non-executive members of the board, covering everything from ‘what is the cloud?’ to information security and the EU’s general data protection regulation.

How have you worked with the technology and IT vendor market to achieve your business goals? How have you been able to influence IT suppliers and successfully manage your partnerships/relationships with large IT companies, SMEs and startups?My focus in the vendor market has been on building constructive strategic relationships with a number of key suppliers. This includes a number of larger partners, but also some smaller SMEs who are sometimes able to respond more flexibly. My aim has been to marry the innovation and flexibility of SMEs and startups with the delivery capability of larger partners. An example of this is our recent ‘big data and analytics’ workshops, where we invited a range of partners to present to each other, alongside us, their insights and capabilities to try to foster a spirit of joint working.

I see my role as being to build relationships and constructively challenge vendors to perform better and see themselves as being part of who we are as NHSBT. Occasionally, in the last year, that challenge has involved parting company with vendors whose approach did not fit.

How have you tried to develop the diversity of your team?This is an area of considerable challenge, but one we are committed to addressing. We have seen the number of women working in our IT teams grow considerably this year, but they are still underrepresented, particularly at more senior levels. Likewise, we have seen an increase in ethnic diversity among senior managers, but not at the highest level.

As an organisation we are tackling this by, for example, ensuring that we have a BAME representative on the interview panel for all management appointments. We have also started to engage external organisations such as the Everywoman Network to encourage and empower those women who do work within our teams.

Describe how you organise and operate IT and how this aligns effectively with business strategy and operationsIT is broadly split between a delivery function (including architecture, analysis, development and testing) and a services and operations function (responsible for service management and compliance, and leadership of the infrastructure technologies). To support our emerging cloud-first delivery model, we have created a floating group between the two to start to build a dev/ops function.

A particular change this year has been to refocus the operational teams (apart from a very small core 24/7 capability) around technology families – to own the technology groups and to take ownership of the replacement of the underlying technologies and innovation.

Our service management function is directly aligned to our business units to ensure there is a responsive service. We provide business partners from the IT senior management team to each of the operational business unit leadership teams.

What strategic technology deals have you made in the last year and who are your main suppliers and IT partners?Key new deals have been with Microsoft (to provide Office 365 and Dynamics CRM and AX (now Dynamics 365)) and with IBM (to provide the business process management on cloud solution and the operational decision manager rules engine). In both cases we have brought in specialist implementation partners to help with technologies – Capgemini on the Microsoft technologies, and an SME, T-Impact, for the IBM technologies. We have also implemented the MuleSoft ESB as our integration engine.

Our other strategic suppliers are Vodafone for networking and telephony, SCC for infrastructure and datacentres, Apadmi for digital development, and Sapient for additional web development.

What are your key strategic aims for next year?Key priorities for next year are:

The roll-out of Dynamics CRM to enable flexible management of donor appointments, automated and intelligent marketing capabilities to attract new donors, and a digital transplant waiting list for patients needing an organ transplant.

We also hope to make significant steps forward in implementation of Dynamics AX to provide insight and efficiencies in our supply chain, replacing a 20-year-old legacy application.

We will extend our cloud-based organ allocation schemes, first to lung allocation and then to liver allocation, which has the potential to save tens of lives every year through better allocation arrangements.

We will look to land our big data trials and invest in those that provide solid analytics to enable us to manage our donor base more effectively and allocate products better to save and improve lives.

We will be extending our digital agenda and services to provide new ways for donors to interact with us and to enable them to complete checks before arriving to donate so that appointment slots are better managed.

We will be expanding our connectivity services to ensure that we can establish a reliable connection in as many of the remote locations that we visit as possible.

How are you preparing for any impacts Brexit might have on your organisation?We have identified an executive-level lead on Brexit and completed a full risk assessment, including of our IT services. The key issues for us are around the regulatory frameworks in which we operate, our reliance on key staff from other EU countries, the need for ongoing funding for innovation and research, and ensuring that our contracts respond to the changing circumstances. On the technology side, an area of increasing focus is data residency and the regulatory framework, particularly as it affects cloud services.

YOUR ROLE

When did you start your current role?October 2014

What is your reporting line?Chief executive

Are you a member of the executive leadership?Yes

Are you a member of the board of directors?Yes

What other emerging roles does your organisation have and what is their relationship to you?The chief technology officer reports to me.

How often do you meet with your organisation’s CEO or equivalent?Monthly formally; weekly informally.

How many people at your organisation does your function supply services to?5,000

BUDGETS

What is your annual IT budget, or your spend as a proportion of the organisation’s revenue?£19.5m

What percentage of your budget is operational spend (ie keeping the lights on) and how much new development (ie innovation, R&D, exploratory IT)?60/40 operational/new Developments, but significant additional investment in new developments through programme funding.

CIO INFLUENCES

Rank the following sources of advice/information in order of importance:

Analyst houses

Consultants

Media

Industry bodies

CIO peers

IT SECURITY

Has your organisation detected a cyber intrusion in the last 12 months?Yes

Are you expecting an increase in budget specific to security in order to tackle the cyber threat?No

Does your organisation have a designated security professional – CISO or otherwise – and what is their relationship to you?Yes, they report to the chief technology officer, who reports to me.

RECRUITMENT

Are you finding it difficult to recruit the talent you need to drive transformation?Yes

Has recruitment and retention risen up your agenda as a CIO?Yes

Does your IT organisation operate an apprenticeship scheme?Yes

How many employees are there in your IT team?162

Are you increasing your headcount or planning to bring skills and the ability to react to needs in-house?Yes

TECHNOLOGY

Which technologies or areas are you expecting to be investing in over the next year?

cloud

data analytics/business intelligence

ERP

CRM

machine learning/artificial intelligence

devices (desktop)

networking/communications.

Which technologies or areas are you expecting to be investing in over the next one to three years?

cloud

data analytics/business intelligence

ERP

IoT

machine learning/artificial intelligence

devices (mobile)

wearables.

What emerging technologies are you investigating or expect to have a big impact on your sector or organisation?We expect deep learning to have a significant impact in terms of understanding donor and patient outcomes. We are looking at cognitive computing to explore the potential for automated intelligent allocation decision-making. And we are looking at robotics and IoT to improve our manufacturing processes.

THE EU

Does your organisation do a significant amount of trade with the EU?No